Worrying about communication...

Next Monday I start on the next big adventure of my university degree - my three day Social Work student placement. I've bought clothes, I've mapped the route and worked out the right bus number... I've even decided which bag I'm going to take (don't laugh... I like to be organised!).

But while my fellow students are busy worrying about Systems Theory, the importance of attachment and how to fill out a CAF form I have a slightly bigger concern.

Sure all those things are very important and I'm stressing about them as well, but for me it all boils down to communication.

I am, at times, a ridiculously independent person and this is occasionally my downfall... Although I'll have an interpreter with me on placement I feel strongly about the need to communicate for myself.

Through numerous discussions and mock-up Social Work interviews what I've discovered is that it's very difficult to build the same relationship with a service user when everything they say, all the little details, the private stuff, the emotion is being passed back and translated through an interpreter.
There are numerous problems I've encountered so far....

• where to look? To me as a Social Work student it seems vital to maintain some sort of open communication through eye contact with a service user.... Should I watch them while they speak and then turn to the interpreter for clarification of things I've missed? Or should I simply watch the interpreter and not have that same level of passive understanding... 
• confidentiality and cultural differences... This is one that I've had big problems with and Ive definitely learned from my mistakes so far. Many people may see what they say to a Social Worker as confidential just as they would their GP. But throw an interpreter into the mix and many people become worried and stressed about confidentiality... This seems to be particularly problematic as my (amazing!!) interpreter is Asian - this sounds random I know - but some Asian families may feel uncomfortable with his presence as they may feel the interpreter will "feedback" to the community. 

In terms of confidentiality I think the most important thing is to remember that although I, and other deafies, may be used to working with an interpreter and are therefore aware of the confidentiality agreements (strict ones!!) they agree to many people will have no experience of interpreting and will not know this. It's important to reassure them early on of this.

Communication affects other areas than working with service users...

I'm not particularly concerned about Team Meetings or Inter-professional meetings etc as having an interpreter for these will solve any difficulties - although I do wonder how I'll ever get a word in edgeways when I become a qualified Social Worker...

What bothers me though is our university portfolio... You see this is made up/completed by us writing detailed answers to questions that we must ask the Social Workers we are shadowing throughout the placement...  This is another of those independence things. Ideally in a 1:1 situation I'd like to able to demonstrate my knowledge and get my feelings across, as well as asking the questions I need to get answers to. But what if I misunderstand? And what if... (this is my biggest fear) the social worker I'm shadowing has a strong accent and I really can't understand a word they say... How awkward could that make my week? Sorry... I can lipread that person, but not you cos... well... I don't understand your accent.

I guess the only other thing worrying me is general deaf awareness... I hope my Social Work team will be clued up enough to realise that I'm not going to be answering any phones unless they're text phones and that if I don't reply I'm not ignoring anyone I genuinely haven't heard.
I'd hope they would know these things... but from past experience, well, you'd be amazed.

Anyways, I'll be sure to write about placement and how it went next week!! But until then if any deaf social workers out there want to reassure me please get in touch!! Or if anyone in general has any tips...

How not to offer a medical service...

I have a deaf friend around the same age as me who recently discovered she was pregnant, although she is in a relationship she was very unsure about whether or not she wanted to keep the baby and in the end decided to have an abortion.

She told me her story recently and I asked if I could blog about it to raise awareness of the issues she faced.

As I said my friend was very unsure about what she wanted to do and after speaking to her parents, who are both hearing, they decided that the best thing to do would be to get her some deaf friendly, impartial advice from a local service.
After a conversation with the GP it was decided that she would have an appointment at the local BPAS clinic, her mother called and made an appointment and spoke directly to the receptionist explaining that my friend is deaf and uses BSL. The receptionist assured her that everything would be sorted and that the counsellor she saw would be aware of her communication needs.

The next week my friend arrived at the clinic on her own, it was on a main road and in order to get into the building she had to press a buzzer. She pressed the buzzer and quickly realised it was an intercom system, she waited a minute and then pressed again before waiting a few seconds and hoping someone was listening explained that she was deaf and gave her name. She was buzzed into the building.

When she got to the reception she gave her name to a receptionist who then disappeared behind a computer screen and mumbled a bit. My friend again explained she was deaf and the receptionist apologised.

She waited half an hour in the waiting room before going back to the reception desk, worried she hadn't heard her name being called. The receptionist explained the clinic was running late.

Eventually a counsellor came out and called my friends name and took her through to another room. The counsellor was talking with her back to my friend who was unsure what she was saying. Again she explained she was deaf - the counsellor had not been told and there was no interpreter.

Deaf awareness aside it quickly transpired that the counselling service was not particularly impartial. My friend was pressured to have an abortion and told that she could have all the medical checks that day and set a date if she wanted.

The appointment ended after half an hour. My friend still doesn't know the name of the counsellor she saw. She was charged £60 for an hour appointment.

Skipping over the next few weeks in the end my friend decided that she wanted to have an abortion. She felt it wasn't the right time for her to have a baby and that she couldn't support it and it wouldn't be fair to expect her own parents to help her out. She also wanted to continue studying.

My friend was given an appointment at a local abortion clinic and although the clinic were told by the nurse that my friend was deaf her mother was advised to contact them to ensure she would be able to accompany my friend and help her with communication.

Her mother phoned the clinic and was told categorically that she would not be able to stay with my friend even though she was deaf. They wouldn't book an interpreter as they had a member of staff with BSL level 1 and it was procedure that nobody could accompany a patient.

My friends mother asked to speak to the manager and eventually received a phone call back. The manager again refused to book an interpreter, my friends mother explained that someone with level 1 BSL would not be able to communicate for my friend and that my friend was getting increasingly distressed by the situation. The manager also said that they could not state for sure that the nurse with level 1 BSL would be present all the time, they would likely only be there when my friend was in recovery.

My friends mother explained that my friend would not be able to take on any information given to her and would feel incredibly isolated.

After more than a week of phone calls the clinic eventually gave in and booked an interpreter, however they were only booked for 3 hours and had to leave for their next booking before my friend had properly come round from recovery and had her post-abortion care explained to her.

The nurse on the recovery ward handed my emotional and groggy deaf friend her hearing aid and told her she had to put them in and "listen". The nurse had an accent and my friend had no idea what she was saying.

The clinic sent her home half an hour after she had come round, with no painkillers as she was a danger because they couldn't effectively communicate with her.

Through all this the one thing my deaf friend most wanted me to tell you was that the attitudes of the midwifes when she went for an emergency scan at the local hospital were amazing. As soon as they realised she was deaf they made every effort to ensure she understood, were clear and gave her extra time to ask any questions she wanted and even gave her some of the impartial medical advice she needed.

I feel like the story I've told is pretty self explanatory in the problems it highlights. I was shocked when my friend told me her story and I can only hope that she had a run of bad luck in terms of services. I'm aware that her parents have complained to BPAS and I really hope they get the answers and the apology they deserve.